System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints

ABSTRACT

The system and method serves in facilitating replacement of comminuted bone fractures or portions thereof adjacent bone joints. The system and method employs a prosthesis to replace at least a portion of the comminuted bone fractures. The prosthesis serves in reproducing the articular surface of the portion or portions of the comminuted bone fractures that are replaced. In doing so, the prosthesis serves in restoring joint viability and corresponding articulation thereof.

RELATED APPLICATIONS

This application is a divisional of U.S. application Ser. No.13/282,810, filed Oct. 27, 2011 (U.S. Pat. No. 8,870,963); which claimsthe benefit of U.S. Provisional Application No. 61/407,072, flied Oct.27, 2010, entitled “Proximal Humerus Hybrid Prosthesis Plate and Methodof Use Associated Therewith”; all of which are incorporated by referenceherein.

BACKGROUND

Field of the Invention

The present invention is ever generally related to a medical device andmethod for use thereof for facilitating replacement of comminuted honefractures. In particular, the present invention is related to a systemand method for use thereof to aid in the replacement of comminuted bonefractures adjacent bone joints to restore joint viability. Morespecifically, the present invention relates to a system and method foruse thereof for replacing comminuted bone fractures adjacent joints byproviding a prosthesis to replace the fractured bone to facilitaterestoration of movement associated with the bone joint.

Description of the Prior Art

Comminuted bone fractures adjacent joints oftentimes result insignificant fragmentation of the bone. In fact, these types of bonefractures can often result in portions of the bone being severelyfragmented. That is, the number of fragments created by these types ofbone fractures pose difficulties in repairing the bone. Bone plates haveoftentimes been used to aid repair of the comminuted bone fractures.However, even with use of bone plates, the comminuted bone fractures maynot be adequately reconstructed. For example, if severely fragmented,the proximal and distal end portions of a humerus may not bereconstructible. As such, there is a need for a prosthesis affordingreplacement of the comminuted bone fractures or portions thereof torestore joint viability. The prosthesis can be used when the comminutedbone fractures need substantial support to aid repair or areirretrievably fragmented. Such a prosthesis, for example, can beconfigured to repair the proximal and distal ends of the humerus.

SUMMARY OF THE INVENTION

The present invention in one embodiment contemplates a method forreplacing at least a portion of a comminuted humeral head, the methodincluding the following acts. A prosthesis is provided that has anexterior portion having an exterior surface, and an interior portionhaving at least one aperture formed therein, the exterior surfaceapproximating the surface of the at least a portion of the comminutedhumeral head in size and shape, and the at least one aperture of theprosthesis being configured to receive at least one fastener therein. Abone plate is provided that has at least one opening formed therein, theat least one aperture of the bone plate being configured to receive theat least one fastener therethrough. At least a portion of the comminutedhumeral head is removed. The bone plate is attached to at least aportion of a humerus. The at least one aperture of the prosthesis isaligned with the at least one opening of the bone plate. The at leastone fastener is inserted through the at least one opening and into theat least one aperture. The prosthesis and the bone plate are securelyattached to one another across the humerus using the fastener.

In another preferred embodiment, the present invention contemplates asystem for replacement of at least a portion of a comminuted humeralhead. The system includes a prosthesis, a bone plate, and at least onefastener. The prosthesis has an exterior portion having an exteriorsurface and an interior portion having at least one aperture formedtherein, the exterior surface being sized and shaped to approximate thesurface of the at least a portion of the comminuted humeral head, andthe at least one aperture of the prosthesis configured to receive atleast one fastener therein. The bone plate including at least oneopening formed therein, the at least one opening of the bone plate beingconfigured to receive the at least one fastener therethrough. The atleast one fastener having a first end for insertion through the at leastone opening and into the at least one aperture, the at least onefastener being configured to secure attachment of the prosthesis and thebone plate to one another across portion of a humerus.

In yet another preferred embodiment, the present invention contemplatesa method for replacing at least a portion of a fractured capitellumand/or a fractured trochlea, the method including the following acts. Anapparatus is provided that has a prosthesis portion and a plate portion,the prosthesis portion having an exterior surface, and the plate portionincluding a first leg portion extending outwardly from the prosthesisportion and a second leg portion extending outwardly from the prosthesisportion. At least a portion of the fractured capitellum and/or thefractured trochlea is removed. The prosthesis portion is sized andshaped according to the portion of the fractured capitellum and/or thefractured trochlea removed, the prosthesis portion having an exteriorsurface approximating the exterior surface of the removed portion of thefractured capitellum and/or the fractured trochlea. The prosthesisportion is positioned relative to the humerus. The first leg portion isattached to the lateral column of the humerus and the second leg portionis attached to the medial column of the humerus.

It is understood that both the foregoing general description and thefollowing detailed description are exemplary and exemplary only, and arenot restrictive of the invention as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of the specification, illustrate preferred embodiments of theinvention. Together with the description, they serve to explain theobjects, advantages and principles of the invention. In the drawings:

FIG. 1 is a perspective view of a first embodiment of a system forfracture repair and/or replacement for use with and depicted as attachedto a proximal portion of a humerus;

FIG. 2 is the perspective view of FIG. 1 showing a humeral headprosthesis, an extension portion, and fasteners of the first embodimentof the system in phantom with respect to the humerus;

FIG. 3 is a perspective view of a second embodiment of the system forfracture repair and/or replacement for use with a distal portion of thehumerus;

FIG. 4 is a front elevational view of the second embodiment of thesystem depicted in FIG. 3;

FIG. 5 is a side elevational view of the second embodiment of the systemdepicted in FIGS. 3 and 4;

FIG. 6 is a cross-sectional view of the second embodiment of the systemdepicted in FIGS. 3-5 taken along Line 6-6 of FIG. 4; and

FIG. 6A is a alternative cross section for the second embodiment of thesystem depicted in FIGS. 3-6.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The systems for fracture replacement of comminuted bone fractures orportions thereof and the method for use of the system are depicted inthe accompanying drawings. The systems of the present invention providea prosthesis affording replacement of the comminuted bone fractures orportions thereof. While the below-described systems are used inassociation with the proximal and distal end portions of a humerus, thepresent invention is not limited thereto. That is, the system and methodof the present invention can be configured for use elsewhere in thehuman body.

A first illustrative embodiment of the system is generally indicated bythe numeral 10 in FIGS. 1 and 2, and a second illustrative embodiment ofthe system is generally indicated by the numeral 100 in FIGS. 3-6A.First system 10 is used in replacing a fractured humeral had or portionsthereof at the proximal end of the humerus and second system 100 is usedin replacing a fractured capitellum and/or a fractured trochlea orportions thereof at the distal end of the humerus. In doing so, firstand second systems 10 and 100 serve to repair the proximal and distalends, respectively, of the humerus, and serve in restoring jointviability. The components, of each of systems 10 and 100 are constructedof metal or other artificial material suitable for human implantation.

First system 10 is provided to facilitate replacement of a humeral heador portions thereof (not shown) at the proximal end of a humerus H(FIGS. 1 and 2) that have been irretrievably fragmented. Furthermore,while first system 10 is depicted replacing the humeral head or portionthereof, first system 10, for example, could be configured for replacingportions of a distal ulna. First system 10 includes a head portion 12(or prosthetic portion), an optional extension portion 14 (of the medialcalcar), and a bone plate 16. Head portion 12 serves as prosthesis forreplacement of the humeral head or portions thereof, and bone plate 16is configured to provided a rigid structure for attaching head portion12 and extension portion 14 thereto. Extension portion 14 providesadditional structural integrity, but depending on the needs of thepatient, may not be necessary.

Bone plate 16 is attached to surgical neck SN of humerus H. Bone plate16 is configured to receive one or more bone screws 18 therethrough forattachment to surgical neck N. Bone screws 18 are exclusively used forattachment of bone plate 16 to surgical neck SN.

Bone plate 16 also is configured to receive fasteners (such as bolts,posts, and/or screws) 20 and 22 for engagement with head portion 12 andextension portion 14, respectively. If fasteners 20 and 22 are boltsand/or screws, then fasteners 20 and 22 could threadably engage headportion 12 and extension portion 14, respectively, to facilitateattachment. Furthermore, if fasteners 20 and 22 are posts, thenfasteners 20 and 22 could be attached to head portion 12 and extensionportion 14, respectively, using interference fits therebetween. Thus,whether fasteners 20 and 22 are bolts, posts, and/or screws, thefasteners, and head portion 12 and extension portion 14 would includecomplementary structures facilitating attachment.

To facilitate engagement of bone plate 16 with head portion 12 andextension portion 14 using fasteners 20 and 22, respectively, bone plate16 includes openings 24 and 26 therethrough. Openings 24 are provided ator adjacent the upper portion of bone plate 16 for receiving fasteners20, and openings 26 are provided at or adjacent the middle portion ofbone plate 16 for receiving fasteners 22. After insertion thereofthrough bone plate 16, fasteners 20 and 22 engage head portion 12 andextension portion 14, respectively, to provide for the rigid attachmentof humeral head prosthesis 10 to humerus H. In addition to threads (notshown) or structures (not shown) for providing for an interference fitto facilitate engagement with head portion 12 and extension portion 14,fasteners 20 and 22 can include threads (not shown) for engagingcomplementary threads (not shown) provided in openings 24 and 26 to lockfasteners 20 and 22 to bone plate 16. Moreover, fasteners 20 and 22could include threads facilitating attachment to portions of humerus Hthat fasteners 20 and 22 extend through.

Head portion 12 can be sized and shaped according to the portions of thehumeral head being replaced. As such, portions of head portion 12 servein reproducing the articular surface of the proximal humerus that isbeing replaced using system 10. Thus, if only a portion of the humeralhead requires replacement, head portion 12 can be sized and shaped toapproximate the size and shape of the portion of the humeral head beingreplaced. However, if the entirety of the humeral head is beingreplaced, head portion 12 can be sized and shaped to approximate thesize and shape of the entirety of the humeral head. As depicted in FIGS.1 and 2, head portion 12 is sized and shaped to replace the entirety ofthe humeral head.

Head portion 12 includes an exterior-facing portion having an exteriorsurface 30, and an interior-facing portion of having an interior surface32, columns 34, and apertures 36 for receiving fasteners 20 therein.Apertures 36 can include complementary threads (not shown) or structures(not shown) for providing an interference fit to facilitate engagementwith fasteners 20. As depicted in FIGS. 1 and 2, exterior surface 30 isconvex and is configured to mimic the shape of the humeral head orportions thereof to reproduce the articular surface of the proximalhumerus being replaced. Accordingly, portions of exterior surface 30 canbe highly polished or lubricated. Furthermore, as depicted in FIG. 2,interior surface 32 is concave, and columns 34 extend outwardly frominterior surface 32.

Columns 34 include apertures 36 for receiving fasteners 20 therein.However, the present invention is not limited to using columns 34. Forexample, if interior surface 32 is flattened (rather than concave) andan adequate depth of material is provided between exterior surface 30and interior surface 32, apertures 36 could be formed through interiorsurface 32 into the material provided between exterior surface 30 andinterior surface 32.

Furthermore, relief holes 38 are provided through columns 34 tocommunicate with apertures 36. Relief holes 38 allow tissues, fluids,and/or air that were present in apertures 36 (prior to insertion orfasteners 20 therein) to be expelled therefrom as fasteners 20 aretightened in position.

While head portion 12 is depicted in FIGS. 1 and 2 as being a singleintegral component, head portion 12 can be composed of two or moreelements that can be integrated with one another during implantation ofsystem 10. For example, head portion 12 could be composed of a baseplate (not shown) and a portion (not shown) including exterior surface30. The base plate would first be attached to bone plate 16 usingfasteners 20, and then the portion including exterior surface 30 wouldbe attached to the base plate. The base plate and the portion includingexterior surface 30 could include a complementary attachment mechanismshared therebetween to facilitate integration thereof. As such, astandard sized and shaped, base plate could be utilized, and only theportion including exterior surface 30 would be sized and shapedaccording to the portions of the humeral head being replaced.

Extension portion 14, as depicted in FIG. 2, depends downwardly fromhead portion 12. Extension portion 14 is inserted into medullary cavityMC, and is configured to interface with the bone adjacent medullarycavity MC. Furthermore, using fasteners 22, extension portion 14 can beattached to the medial cortex of humerus H. To that end, extensionportion 14 includes apertures 40 for receiving fasteners 22. Likeapertures 36 of head portion 12, apertures 40 can also includecomplementary threads (not shown) or structures (not shown) forproviding an interference fit to facilitate engagement with fasteners22.

Rather than or in addition to using fasteners 20 and 22, integral posts(not shown) formed with bone plate 16 could be used to attach bone plate16 with head portion 12 and/or extension portion 14. For example, anintegral post that extends outwardly from bone plate 16 could bepositioned adjacent apertures 24. Furthermore, a portion of the integralpost could be received in one of apertures 36, and the integral post andthe one of apertures 36 could include complementary structures (notshown) facilitating attachment therebetween.

Moreover, while fasteners 20 and 22 are shown as being inserted throughbone plate 16 and into head portion 12 and extension portion 14,respectively, head portion 12, extension portion 14, and bone plate 16could be configured to provide the opposite arrangement—fasteners 20 and22 could be inserted through head portion 12 and extension portion 14,respectively, and into bone plate 16. As such, head portion 12,extension portion 14, and bone plate 16 would include complementaryconfigurations to afford such an arrangement. For example, head portion12 could include an opening (not shown) extending through theexterior-facing portion and the interior-facing portion thereof. Thus, afastener (similar, if not identical, to fastener 20) could be insertedthrough such an opening and into a corresponding aperture formed in boneplate 16.

To secure attachment of first system 10 to humerus H using theconfiguration thereof depicted in FIGS. 1 and 2, the fractured humeralhead or portions thereof are removed from adjacent humerus H. Bone plate16 is initially attached to surgical neck SN using bone screw 18.Thereafter, openings 24 and 26 through bone plate 16 can be used asdrill guides for receiving a drill to create alignment holes throughhumerus H. The alignment holes created by the drill will ultimatelyafford alignment between holes 24 in bone plate 16 and apertures 36 inhead portion 12, and between holes 26 in bone plate 16 and apertures 40in extension portion 14. Once the alignment holes are created, headportion 12 is positioned with respect to humerus H. Fasteners 20 and 22are then inserted through openings 24 and 26 into apertures 36 and 49,respectively. Tightening of fasteners 20 and 22 in holes 36 and 40 serveto secure engagement of head portion 12 to humerus 10. As such, headportion 12, extension portion 14, and bone plate 16 and fasteners 20 and22 extending therebetween provide an effective structural latticeallowing head portion 12 to provide an effective replacement for thehumeral head or portions thereof that are severely fractured. Viareplacement of the humeral head or portions thereof using first system10, the viability of the shoulder joint adjacent to head portion 12 canbe restored.

As discussed above, second system 100 is provided to facilitatereplacement of a fractured capitellum and/or a fractured trochlea orportions thereof (not shown) at the distal end of the humerus. Asdepicted in FIGS. 3-6A, second system 100 includes a prosthetic portion102 and a plate portion 104. Prosthetic portion 102 and plate portion104 are depicted in FIGS. 3-6A as being formed integrally with oneanother. However, second system 100 is not limited thereto. Prostheticportion 102 and plate portion 104 can be formed separately from oneanother and then cooperatively engaged to for integrated with) oneanother. For example, prosthetic portion 102 and plate portion 104 couldbe fastened to one another using a fastener extending through portionsthereof during implantation of system 100. Furthermore, while secondsystem 100 is configured to replace the fractured capitellum and/or thefractured trochlea or portions thereof, second system 100 is not limitedthereto. For example, second system 100 also could be configured toreplace fractured portions of the humerus such as the lateralepicondyle, the olecranon fossa, and/or medial epicondyle.

Prosthetic portion 102 serves as a prosthesis for replacement of thefractured capitellum and/or the fractured trochlea or portions thereof.As such, prosthetic portion 102 could be shaped to replace the entiretyof both of the fractured capitellum and the fractured trochlea, orvarious portions of the fractured capitellum and/or the fracturedtrochlea. Furthermore, plate portion 184 is configured to provide arigid structure for attaching prosthetic portion 102 to the humerus.

As depicted in FIGS. 3-5, prosthetic portion 102 includes a capitellumportion 106 and a trochlea portion 108. As discussed above, the entiretyof the fractured capitellum and/or the fractured trochlea or portionsthereof can be replaced using prosthetic portion 102. Thus, prostheticportion 102 includes an exterior surface 110 (extending over capitellumportion 106 and trochlea portion 108) that can be sized and shapedaccording to the portions of the fractured capitellum and/or thefractured trochlea requiring replacement. As such, portions ofprosthetic portion 102 serve in reproducing the articular surface of thedistal humerus that is being replaced using system 100. Accordingly,portions of exterior surface 110 can be highly polished or lubricated.

For example, if only the entirety of fractured capitellum requiresreplacement, then prosthetic portion 102 (and exterior surface 110thereof) would be sized and shaped to approximate the entirety of thecapitellum and could incorporate only capitellum portion 106.Furthermore, if only the entirety of the fractured trochlea requiresreplacement, prosthetic portion 102 (and exterior surface 110 thereof)would be sized and shaped to approximate the entirety of the trochleaand could incorporate only trochlea portion 108. However, if onlyselected portions of the fractured capitellum and the fractured trochlearequire replacement, then prosthetic portion 102 (and exterior surface110 thereof) would be sized and shaped to approximate the selectedportions by incorporating corresponding portions of capitellum portion106 and trochlea portion 108.

Furthermore, prosthetic portion 102 can be constructed to be hollow toinclude a cavity 112. As depicted in FIGS. 3 and 6, cavity 112 is formedbehind exterior surface 110, and thus, an interior surface 114 (ofcavity 112) is opposite exterior surface 110. Cavity 112 can be filledwith bone graft materials, and/or portions of the fractured capitellumand the fractured trochlea that the prosthetic portion 102 is being usedto replace. Alternatively, prosthetic portion 102 can be constructed ofsolid material as depicted in the cross-sectional view of FIG. 6A. Assuch, prosthetic portion 102 would be formed of solid materialapproximating the portions of the fractured capitellum and/or thefractured trochlea being replaced.

As depicted in FIGS. 3 and 4, plate portion 104 extends outwardly fromprosthetic portion 102, and includes a body portion 120, a first legportion 122, and a second leg portion 124. First leg portion 122 extendsoutwardly from capitellum portion 106, and second leg portion 124extends outwardly from trochlea portion 108. Furthermore, first andsecond leg portions 122 and 124 extend from prosthetic portion 102 toterminate at body portion 120.

An aperture 130, as depicted in FIGS. 3 and 4 is formed betweenprosthesis portion 102 and first and second leg portions 122 and 124.Furthermore, plate portion 104 includes a front surface 132 and a rearsurface 134 opposite the front surface 132. As discussed below, portionsof rear surface 134 (which encompasses body portion 120, first legportion 122, and second leg, portion 124) is engaged to portions of thehumerus. As such, rear surface 134 can be at least in part concave (FIG.6) to facilitate such engagement.

Body portion 120 is attached to the shaft (not shown) of the humerus.Furthermore, first leg portion and second leg portions 122 and 124 areattached to the humerus—first leg portion 120 is attached to the lateralcolumn (not shown) and second leg portion 122 is attached to the medialcolumn (not shown). To that end, body portion 120, first leg portion122, and second leg portion 124 can include various apertures 126.Apertures 126 can be configured to receive bone screws (not shown)therethrough to attach plate portion 104 to the humerus.

In addition to threads (not shown) for engaging the humerus, the bonescrews used to attach the plate portion thereto can include threads (notshown) for engaging complementary threads (not shown) provided inapertures 126 to lock the bone screws to plate portion 104. Furthermore,if necessary, a second plate portion (not shown) can be positioned onthe opposite side of the humerus of plate portion 104 to afford anotherattachment structure for plate portion 104. Thus, additional fasteners(such as bolts and/or screws) could be used to interconnect plateportion 104 and the second plate portion to further enhance the rigidityof the structure attaching prosthetic portion 102 to the humerus.

To secure attachment of the first system 100 to the humerus, thefractured capitellum and/or the fractured trochlea or portions thereofare removed from adjacent the humerus. Thereafter, plate portion 104 isattached to the humerus with or without drilling into the humerus. Ifholes are drilled in the humerus to receive the bone screws, apertures126 through plate portion 104 can be used as drill guides for receivinga drill. The bone screws are thereafter inserted through apertures 126and into the humerus. Using the bone screws to facilitate attachment tothe humerus, body portion 120 is attached to the shaft, first legportion 120 is attached to the lateral column, and second leg portion122 is attached to the medial column. The attachment of body portion120, first leg portion 122, and second leg portion 124 to the humerusprovides the structural rigidity necessary to allow prosthetic portion102 to provide an effective replacement for the fractured capitellumand/or the fractured trochlea or portions thereof. Via replacement ofthe fractured capitellum and/or the fractured trochlea or portionsthereof using second system 100, the viability of the elbow jointadjacent to prosthesis portion 102 can be restored.

In summary, systems 10 and 100 for replacement of comminuted boneportions and the method for use thereof provide a prosthesis affordingreplacement of the comminuted bone fractures or portions thereof.Furthermore, while systems 10 and 100 are used in association with theproximal and distal end portions, respectively, of the humerus, thesystem and method of the present invention can be configured for useelsewhere in the human body. Other embodiments of the invention will beapparent to those skilled in the art from consideration of thespecification and practice of the invention disclosed herein.Accordingly, it is intended that the specification and examples beconsidered as exemplary only.

What is claimed is:
 1. A system for replacement of at least a portion ofa comminuted humeral head of a humerus, the system comprising: aprosthesis having an exterior portion having an exterior surface and aninterior portion having at least one first aperture and at least onesecond aperture formed therein, said exterior surface being sized andshaped to approximate the surface of the at least a portion of thecomminuted humeral head, said at least one first aperture of saidprosthesis configured to receive at least one first fastener therein,and said at least one second aperture of said prosthesis configured toreceive at least one second fastener therein; a bone plate including anupper portion adapted to attach to the humerus at a position proximate asurgical neck thereof, and an elongated lower portion adapted to attachto a shaft of the humerus, said upper portion including at least onefirst opening and at least one second opening formed therein, said atleast one first opening and said at least one second opening beingconfigured to receive said at least one first fastener and said leastone second fastener, respectively, therethrough, said elongated lowerportion of said bone plate including at least one third opening formedtherein, said at least one third opening being configured to receive atleast one third fastener therethrough; and said at least one firstfastener, said at least one second fastener, and said at least one thirdfastener each having a first end for insertion through said at least onefirst opening, said at least one second opening, and said at least onethird opening, and into said at least one first aperture, said at leastone second aperture, and the shaft of the humerus, respectively, said atleast one first fastener and said at least one second fastener beingconfigured to secure attachment of said upper portion of said bone plateand said prosthesis to one another across a portion of a humerus, andsaid at least one third fastener being configured to secure attachmentof said elongated lower portion to the shaft of the humerus.
 2. Thesystem of claim 1, wherein at least a portion of said exterior surfaceis convex, and said interior portion includes an interior surface, atleast a portion of said interior surface being concave.
 3. The system ofclaim 2, wherein said interior portion of said prosthesis includes aplurality of columns, said at least one first aperture being formed in afirst of said plurality of columns, and said at least one secondaperture being formed in a second of said plurality of columns.
 4. Thesystem of claim 1, further comprising an extension portion dependingdownwardly from said prosthesis, said extension portion being adaptedfor insertion in the medullary cavity of the humerus.
 5. The system ofclaim 4, further comprising at least one fourth opening formed in saidelongated lower portion, at least one fourth aperture formed in saidextension portion, and at least one fourth fastener being configured forinsertion into said at least one fourth opening and said at least onefourth aperture to secure attachment of said elongated lower portion andsaid extension portion to one another.
 6. A system for replacement of atleast a portion of a comminuted humeral head of a humerus, the systemcomprising: a prosthesis having an exterior portion having an exteriorsurface, an interior portion having at least one first aperture and atleast one second aperture formed therein, and an extension portiondepending downwardly therefrom having at least one third aperture formedtherein, said exterior surface being sized and shaped to approximate thesurface of the at least a portion of the comminuted humeral head, saidextension portion being adapted for insertion in the medullary cavity ofthe humerus, said at least one first aperture of said prosthesisconfigured to receive at least one first fastener therein, said at leastone second aperture of said prosthesis configured to receive at leastone second fastener therein, said at least one third aperture of saidextension portion configured to receive at least one third fastenertherein; a bone plate including an upper portion adapted to attach tothe humerus at a position proximate a surgical neck thereof, and anelongated lower portion adapted to attach to a shaft of the humerus,said upper portion including at least one first opening and at least onesecond opening formed therein, said at least one first opening and saidat least one second opening being configured to receive said at leastone first fastener and said least one second fastener, respectively,therethrough, said elongated lower portion of said bone plate includingat least one third opening formed therein, said at least one thirdopening being configured to receive said at least one third fastenertherethrough; and said at least one first fastener, said at least onesecond fastener, and said at least one third fastener each having afirst end for insertion through said at least one first opening, said atleast one second opening, and said at least one third opening, and intosaid at least one first aperture, said at least one second aperture, andsaid at least one third aperture, respectively, said at least one firstfastener and said at least one second fastener being configured tosecure attachment of said upper portion of said bone plate and saidprosthesis to one another across a portion of a humerus, and said atleast one third fastener being configured to secure attachment of saidelongated lower portion to said extension portion.
 7. The system ofclaim 6, further comprising at least one fourth opening formed in saidelongated lower portion, and a least one fourth fastener configured forinsertion into said at least fourth opening, said at least one fourthfastener being configured to secure attachment of said elongated lowerportion to the shaft of the humerus.
 8. The system of claim 6, whereinat least a portion of said exterior surface is convex, and said interiorportion includes an interior surface, at least a portion of saidinterior surface being concave.
 9. The system of claim 8, wherein saidinterior portion of said prosthesis includes a plurality of columns,said at least one first aperture being formed in a first of saidplurality of columns, and said at least one second aperture being formedin a second of said plurality of columns.
 10. A system for replacementof at least a portion of a comminuted humeral head of a humerus, thesystem comprising: a prosthesis having an exterior portion having anexterior surface, an interior portion having at least one firstaperture, and an extension portion depending downwardly therefrom havingat least one second aperture formed therein, said exterior surface beingsized and shaped to approximate the surface of the at least a portion ofthe comminuted humeral head, said extension portion being adapted forinsertion in the medullary cavity of the humerus, said at least onefirst aperture of said prosthesis configured to receive at least onefirst fastener therein, and said at least one second aperture of saidextension portion configured to receive at least one second fastenertherein; a bone plate including an upper portion adapted to attach tothe humerus at a position proximate a surgical neck thereof, and anelongated lower portion adapted to attach to a shaft of the humerus,said upper portion including at least one first opening formed therein,said at least one first opening being configured to receive said atleast one first fastener therethrough, said elongated lower portion ofsaid bone plate including at least one second opening formed therein,said at least one second opening being configured to receive said atleast one second fastener therethrough; and said at least one firstfastener and said at least one second fastener each having a first endfor insertion through said at least one first opening and said at leastone second opening into said at least one first aperture and said atleast one second aperture, respectively, said at least one firstfastener being configured to secure attachment of said upper portion ofsaid bone plate and said prosthesis to one another across a portion of ahumerus, and said at least one second fastener being configured tosecure attachment of said elongated lower portion to said extensionportion.
 11. The system of claim 10, further comprising at least onethird opening formed in said elongated lower portion, and a least onethird fastener configured for insertion into said at least one thirdopening, said at least one third fastener being configured to secureattachment of said elongated lower portion to the shaft of the humerus.12. The system of claim 10, wherein at least a portion of said exteriorsurface is convex, and said interior portion includes an interiorsurface, at least a portion of said interior surface being concave. 13.The system of claim 12, wherein said interior portion of said prosthesisincludes at least one column, said at least one first aperture beingformed in said at least one column.